Pharmacogenomics and Personalized Medicine (May 2021)
Pharmacogenomics in the United States Community Pharmacy Setting: The Clopidogrel-CYP2C19 Example
Abstract
David F Kisor,1 Natasha J Petry,2,3 David R Bright4 1Manchester University, Department of Pharmaceutical Sciences and Pharmacogenomics, Fort Wayne, IN, USA; 2North Dakota State University, College of Health Professions, Department of Pharmacy Practice, Fargo, ND, USA; 3Sanford Imagenetics, Sioux Falls, ND, USA; 4Ferris State University, Department of Pharmaceutical Sciences, Big Rapids, MI, USACorrespondence: David F KisorManchester University, Department of Pharmaceutical Sciences and Pharmacogenomics, 10627 Diebold Road, Fort Wayne, IN, 46845, USATel +1 260-470-2747Fax +1 260-470-4440Email [email protected]: Pharmacogenomics (PGx) is expanding across health-care practice settings, including the community pharmacy. In the United States, models of implementation of PGx in the community pharmacy have described independent services and those layered on to medication therapy management. The drug–gene pair of clopidogrel-CYP2C19 has been a focus of implementation of PGx in community pharmacy and serves as an example of the evolution of the application of drug–gene interaction information to help optimize drug therapy. Expanded information related to this drug–gene pair has been provided by the US Food and Drug Administration and clinical PGx guidelines have and continue to be updated to support clinical decision-making. Most recently direct-to-consumer (DTC) PGx has resulted in patient generated sample collection and submission to a genetic testing-related company for analysis, with reporting of genotype and related phenotype information directly to the patient without a health-care professional guiding or even being involved in the process. The DTC testing approach needs to be considered in the development or modification of PGx service models in the community pharmacy setting. The example of clopidogrel-CYP2C19 is discussed and current models of PGx implementation in the community pharmacy in the United States are presented. New approaches to PGx services are offered as implementation continues to evolve and may now include DTC information.Keywords: pharmacogenomics, pharmacogenetics, clopidogrel, community pharmacy, implementation
